June 6, 2009 — Gov. John deJongh Jr. and the governors of the other territories of the United States are lobbying to make sure the territories are not forgotten as Congress begins to look at a major overhaul of U.S. health care.
On June 2, deJongh, along with Govs. Felix P. Camacho of Guam, Benigno R. Fitial of the Commonwealth of the Northern Mariana Islands and Luis G. Fortuno of Puerto Rico, sent a letter to both the chairman of the U.S. Senate Committee on Finance, Max Baucus (D-Mont.) and the committee’s ranking minority member, Charles Grassley (R-Iowa) urging support for "fair and equitable treatment of the U.S. offshore areas on health care reform legislation presently pending before the Senate Finance Committee."
"The legislative initiative offers an historic opportunity to address and remedy current discriminatory treatment of U.S. citizens residing in the insular areas of the United States in the critical area of federal health care policy," deJongh wrote.
While Congress has for years legislated incremental improvements in both Medicaid and State Children's Health Insurance Program funding for the offshore territories, the quality and availability of health care here are at a severe disadvantage compared to states because of a cap on federal Medicaid funds and differing matching requirements under the Federal Medical Assistance Percentages formula that determines how much localities have to pony up to match the federal contributions, the governors' letter said.
"Without parity of treatment with the states and fairer apportionment of federal health-care funds, the Territories have not had, and will not have, the resources to develop State-like health care programs for the benefit of their citizens in full compliance with Medicaid and other federal health care law," the four governors wrote in the letter. They called for the immediate elimination of the Medicaid cap and the discriminatory FMAP rate for the Territories as an essential precondition to the development of full-fledged Medicaid programs in the offshore areas.
"We understand that reform proposals that might be enacted by Congress will include a major expansion of the federal Medicaid program as a key element in the effort to expand health care coverage to the uninsured, including the possibility of extending eligibility to all households up to 100 percent of the federal poverty level," the letter said. "Because of the additional requirements that would be imposed on us under full State-like treatment, we believe that Congress should provide appropriate safeguards and additional resources to allow the offshore areas to comply with all of the new requirements."
DeJongh and his three fellow governors described the approach as consistent with the policy options for the offshore areas included in the Senate Finance Committee’s policy option paper. "It balances the need for significantly expanded federal resources with the recognition that full State-like treatment will require significant changes at the Territorial level as well," they wrote.
"Most importantly, it is a practical and realistic way to fulfill the president’s stated commitment to provide equal treatment and ensure that federal health care benefits are available to all Americans, regardless of where they reside."
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